Student:

Practical Nursing Diploma Program

Mid-term/Final Clinical Evaluation Form
LORETA DOGA
Student Number:
xxx xxx xxx

Course:

RPN

Dates:

Section

Sep. 2014

S: Satisfactory

to

04

Dec. 2014

U: Unsatisfactory

Summary of Areas of
Practice

Competent and safe practice

in a professional, legal and
ethical framework

Communication

Caring relational practice

Leadership and advocacy

Student Comments:
Summary of clinical
experience

Faculty Comments:
Summary of clinical
Experience

S: I do practice in a safe and

professional way, following an
ethical framework.

S: X She asks questions for

clarifications. This student
complies with the regulatory
standards, relevant legislation
and the practice settings
policies and procedures, her
client plan of care, regarding
medication administration,
directions or activity of daily
living

S: I do communicate well with

patients and their family
members, staff and co
-workers. Good
communication is key to good
practice.

S: X
She participates in
team discussion, especially
when receiving report in the
mornings of the second day
after she has had information
regarding her clients. She also
takes part in post conference
discussions and activity on a
weekly basis

S: During my experience at
the rehab facility I was able to
build therapeutic relationships
with patients and staff.

S: X
She has
demonstrated sensitivity and
respect for her clients cultural,
religious, belief and values
through the semester. Taking
into consideration the clients,
choice and decision,
especially when one of her
client was upset regarding his
medication she was quite
compassionate and attentive
to needs.

S: During my practice I had

several opportunities to
advocate for my patients
safety and well -being.

S: X
This student
evaluates and refines
leadership skills to develop
solutions and create a positive

environment for her client.

There was one client who
would only respond to her
when she is assign to him. He
would not comply with the
other students
Plans of care: Meeting
Clients Needs and Mutually
Agreed Expected Outcomes

Collaborative Practice

Quality Assurance

Critical Thinking, Problem

Solving and Decision Making

S: Co-operating with other

professionals at the rehab
made easy for me to meet my
patients needs and the
outcomes were as desired.

S: X
She prioritizes
nursing care and intervention
in order to manage her
workload untimed and to
coordinate with the clients
activity in the mornings

S: Collaboration comes
naturally when everyones
interest is on the patients
benefit. I had a great
relationship with other team
members and the outcome
was patients safety and health
improvement

S: X
She collaborate well
with the interprofessional
health care team to achieve
mutually the same agreed
expected outcome for the
residents

S: I always reflect on my ways

of practice and try to improve
everyday.

S: X
She is acting in the
best interest of the client and
protecting the client from any
harm when providing care to
them

S: Critical thinking and

decision -making come with
practice and I do notice
improvement during my direct
involvement with patients care
at the rehab. I took time to
understand patients needs
and that helped me find ways
to solve some problems as I
connected with other health
professionals

S: X
She is using the
decision making and the nurse
client environment frame work
to inform and guide her clients
She is utilizing critical thinking
and problem solving skill to
inform decision- making in all
aspects of her nursing care

I have read and understand this form and its contents

Very good student. Good luck in pre-Grad.
Student Signature:

Date:

Faculty Signature:

Date: